Detecting cognitive decline in community-dwelling older adults using simple cognitive and motor performance tests

Geriatr Gerontol Int. 2020 Mar;20(3):212-217. doi: 10.1111/ggi.13863. Epub 2020 Jan 9.

Abstract

Aim: The objective of this study was to estimate the predictive accuracy of simple cognitive and motor performance tests to detect cognitive decline (CD) in community-dwelling older adults.

Methods: In total, 102 community-dwelling older adults participated in this study. Cognitive function, gait performance and coordinated finger movements were assessed using the Montreal Cognitive Assessment, the 10-m walking test and the finger-tapping test, respectively. We classified the participants into either a CD (n = 60) or a healthy control (n = 42) group.

Results: Significant group differences were found in the visuospatial/executive function subscale score on the Montreal Cognitive Assessment, stride length and total finger tap count. The results of multivariate logistic regression analysis showed that visuospatial/executive function subscale score, stride length and total tap count were the significant predictors for the presence of CD (sensitivity 83.3%, specificity 82.9%, predictive accuracy 83.2%). We also constructed a decision tree model with these three variables to increase the usefulness of our model as a screening tool by assigning a cut-off value for each assessment. The sensitivity and specificity of the model were 88.1% and 85.2%, respectively, with an overall predictive accuracy of 86.4%.

Conclusions: The results of the present study suggest that simple cognitive and motor performance tests have moderate-to-high discriminant validity for the presence of CD in community-dwelling older adults. Addition of such tests might lead to the more accurate detection of early cognitive decline. Geriatr Gerontol Int 2020; ••: ••-••.

Keywords: dementia; geriatric medicine; rehabilitation medicine/physical therapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition
  • Cognitive Dysfunction / diagnosis*
  • Dementia / diagnosis
  • Executive Function / physiology*
  • Female
  • Gait
  • Geriatric Assessment
  • Humans
  • Independent Living
  • Japan
  • Male
  • Mental Status and Dementia Tests / standards*
  • Motor Skills / physiology*
  • Reproducibility of Results
  • Sensitivity and Specificity